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By the time Edwin Alemany was 18, he already had a long, well-documented history of serious mental health issues that included hallucinations, severe depression, and a psychological disorder characterized by hostility and defiant behavior.

He once threatened to blow up his school, occasionally disappeared for 24-hour stretches, and oscillated unpredictably between sweetness and rage.

“At times he can be polite and the next minute he is swearing,” his teacher, guidance counselor, and middle school social worker wrote in a report just after his 14th birthday in September 1998. “Edwin’s moods change dramatically (usually from one day to the next) w/out any apparent precipitant.”

Alemany, who now stands accused of attacking two women in South Boston last month and abducting and brutally murdering 24-year-old Amy Lord, spent several stints in psychiatric hospitals as a teenager. He was prescribed medication and regularly monitored by the state Department of Youth Services and a special Boston Public Schools program for children with learning disabilities and emotional problems.

But after his 18th birthday, care from the state came to an abrupt end, according to his family members. Alemany left DYS custody, dropped out of school, and assumed responsibility for his own mental health care.

“He came out with a huge pack of medicine and he said, ‘I’m not taking these anymore,’” said a brother-in-law who has been a close presence in Alemany’s life since Alemany was 14. He asked not to be named for fear of backlash related to his relative’s alleged crimes.

In the years that followed, Alemany repeatedly came in contact with the criminal justice system, largely for relatively minor crimes like theft and trespassing, according to interviews with several close family members and a review of more than 100 pages of criminal records and childhood mental health documents kept by his family. On at least three occasions, police officers witnessed Alemany threatening to kill himself or others, or acting eratically. But in the documentation of his 14 arrests between September 2002 and March of this year there is no indication that a judge ever ordered a mental health evaluation or that he was otherwise targeted for psychiatric care.

Family members said they believed he received some form of treatment while serving multiple sentences at the Suffolk County House of Correction. Alemany’s defense lawyer, Jeffrey A. Denner, said he was beginning to review Alemany’s psychiatric history but declined to comment further, saying he is awaiting any records that may exist of Alemany’s adult medical history.

Alemany’s immediate relatives, who agreed to be interviewed on the condition they not be named, spoke to a reporter in the living room of their Mattapan home. They said they know another side of Alemany — a loyal and loving son, sibling, and father. They say he maintained a long-term relationship with his girlfriend and relishes taking their 4-year-old daughter to the park and to the beach in South Boston.

He is an avid fisherman who likes to fix cars, they said. He tends a tank of tropical fish and cares for a tiny dog named Lily.

This spring, he stayed up until 3 a.m. filling 300 plastic Easter eggs with candy, money, and trinkets for his daughter and other young relatives to find during a party he organized in his parents’ yard, they said.

YOON S. BYUN/GLOBE STAFF

Booking photos show Alemany at 18, 19, 21, and 25.

“He’s not a monster,” said his mother, red-eyed and speaking softly. “He’s a loving kid.”

But his psychiatric issues began early and seemed to grow with time, his family members said. He was diagnosed with a raft of learning disabilities and attention deficit problems.

In June 1999, when he was 14, he was prescribed Prozac and Dexedrine and admitted for one of his several in-patient stays for psychiatric care, after increasingly aggressive behavior that included throwing a garbage can at a teacher.

“I don’t have to be here,” he told a psychiatrist at Brookline’s Bournewood Hospital, who noted Alemany refused to show remorse or acknowledge a need for help.

He spent four years moving among juvenile detention centers, residential psychiatric hospitals, and his family’s apartment, while floating in and out of McKinley Middle School and McKinley Prep, both highly structured, therapeutic public schools in Boston.

In 2002, when Alemany was 17, his mother signed a youth services department consent form authorizing medications including antidepressants and an antipsychotic drug for her son. The form indicated he was having hallucinations. His relatives said he wrestled with hearing voices for more than a decade and has repeatedly cut and harmed himself while threatening suicide. They said they’ve never seen him be violent toward anyone but himself.

Police records show multiple instances of physical altercations — minor compared to the horrific violence he is accused of committing in July, but also hinting at alarming volatility.

Not long after Alemany left DYS care at 18, in June 2003, the owner of a Roslindale pizza shop spotted him in a median on Washington Street, yelling and punching a traffic sign. When the owner drove past, Alemany hurled a rock at him.

The man — who had sometimes given Alemany and his friends free food at the pizza shop in exchange for washing windows — got out of his truck and threatened to hit Alemany if he didn’t stop. Alemany lunged and stabbed the man in the stomach with a four-inch folding knife, according to a police report and the shop owner.

The man, who asked that his name not be used, said he believed Alemany stabbed him only out of panic and said the boy’s friends told him Alemany was distraught over a girl.

Taken in for booking that night, Alemany “struck his head and face off the plexi-glass window and punched the wall with his right hand, trying to harm himself, and threatened suicide,” the police report said.

In April 2008, police responded to a domestic dispute on Gay Head Street in Jamaica Plain and found holes punched into walls of the apartment and Alemany with cuts on his arms and neck. Neighbors said Alemany’s girlfriend at the time had chased him with a steak knife and thrown the knife at him, while the woman told police she did so only after he yelled at her and punched her.

Each was charged with domestic assault, and the police booking form indicates that Alemany’s record showed him to be on a “suicide watch list” from a previous incarceration. The case was dismissed, apparently since neither Alemany nor the woman wanted to testify.

In January 2010, police found Alemany walking down Morton Street in Dorchester just before 8 a.m. on a Sunday, heaving orange traffic barriers into the roadway. When officers frisked him, they found a knife in his right pocket and what looked like a pistol tucked into his waist — though it turned out to be a BB gun. He was found guilty of disorderly conduct and paid a $100 fine.

Five months later, after crashing a stolen car into a pole, Alemany was taken to Beth Israel Deaconess Medical Center in handcuffs for treatment. With his legs free, his feet in sneakers, he kicked the face of a nurse who tried to insert an IV into his arm, then kicked and spat at the officers who tried to restrain him.

Alemany pleaded guilty to car theft and assault and battery with a dangerous weapon and was sentenced to two years at Suffolk County House of Correction, where he would stay until 2012. Relatives said it was painful to see him incarcerated again, separated from his infant daughter, but that at least he would receive some kind of regular medical attention.

Alemany worked sporadically between jail sentences, family members said. With a criminal record, steady employment eluded him, but he detailed cars and joined his brother-in-law periodically when the latter managed a private security outfit and a moving company.

In September 2012, a woman choked into unconsciousness while walking home in Roxbury came to with a wallet in her hand that police officials now say contained Alemany’s ID. The detective investigating the case at the time did not pursue charges against Alemany, citing a lack of probable cause. Boston police are now reexamining the incident.

In the attacks in late July, police say Alemany punched one woman and stabbed another. He allegedly assaulted Lord as she left her Dorchester Street apartment for the gym early in the morning, dragging her back into the vestibule and viciously beating her. He allegedly then drove her to five ATMs and forced her to withdraw cash. She was found stabbed and strangled to death at Stony Brook Reservation.

At a scheduled arraignment in South Boston District Court July 25, a psychiatrist who interviewed him in court found him overcome by emotion; Alemany had pulled stitches from his hand — which police say he cut while stabbing one of the women — and could barely speak, saying in a whisper that he wanted to kill himself. Alemany was sent to Bridgewater State Hospital for a 20-day competency evaluation.

He is due again in court on Wednesday, pending the competency evaluation.

Alemany’s family members, interviewed recently at their home, said they pray he will be exonerated. They presented a portrait of a close-knit family that lacks the resources to get Alemany the top psychiatric care he needs or the guardianship power to insist he follow any treatment at all.

Maria Cramer of the Globe staff contributed to this report. Eric Moskowitz can be reached at emoskowitz@globe.com.